Report of the Royal Commission on National Health Insurance

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Monograph

Identifikator:: 1740277147

URN:: urn:nbn:de:zbw-retromon-132094

Document type:: Monograph

Title:: Report of the Royal Commission on National Health Insurance

Place of publication:: London

Publisher:: Stationery Office

Year of publication:: 1926

Scope:: XII, 394 S.

Digitisation:: 2020

Collection:: Economics Books

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Document type:: Monograph

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Title:: Reservation by Sir Andrew Duncan and Professor Alexander Gray

Collection:: Economics Books

Mw Q9 MAJORITY REPORT : RESERVATION. RESERVATION BY Sir ANDREW DUNCAN AND Proressor ALEXANDER GRAY. 1. While concurring in the terms of the Report signed by the majority of our colleagues, we consider that there are two further matters which ought not to be ignored in any review of the problems presented to us, more particularly if due weight is to be given to the reactions of our social legislation on the trade and industry of the country. In supplementing our assent to the Majority Report with certain observations on these points, we postulate, as an elementary principle, that in promoting schemes of social legislation the State should avoid incurring any expenditure which is not essential to the achievement of the end in view, and further, that the funds, required and collected by its authority, should be so collected as to involve a minimum disturbance to industrial enterprise. 2. The first point to which we wish to draw attention—the lack of co-ordination in our social services—is one which has been the subject of comment in many quarters. We desire in this place to point out the inconvenience, and by implication the waste, which it occasions. In a sense this question may not be within our Terms of Reference, but it is impossible to survey the field of Health Insurance without realising that the problems of Health Insurance are closely interwoven with wider questions from which, in fact, they cannot be divorced. It would be unjust to say that our social legislation has grown up haphazard, but it is indubitable that the various schemes contrived for the pro- tection of the worker against the accidents of life have been elaborated—doubtless very properly—as and when occasion offered. Poor Law Relief, Old Age Pensions, Health Insurance, Unemployment Insurance, Widows’ Pensions have grown up in large measure independently : when they are reviewed, they are reviewed independently. They are financed in different ways ; they are operated by different agencies. On the possibility of co- ordination, on the alternative methods and machinery of operating a co-ordinated scheme, we have received no evidence, or only incidental evidence; and on all such matters we express no opinion. But we do desire to emphasise that there is here a problem which calls for urgent consideration. It may be that in a co-ordinated scheme different machinery would still be necessary for the administration of different sections of the work undertaken but prima facie it appears reasonable to assume that an economy of expenditure and of effort would be effected by viewing the problem of social insurance as a whole and not sectionally. 3. While we do not dissent from the present arrangements under which the employer’s contribution is on a flat rate pro-

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